3/19/ , American Heart Association 1

Save this PDF as:
 WORD  PNG  TXT  JPG

Size: px
Start display at page:

Download "3/19/2013 2012, American Heart Association 1"

Transcription

1 3/19/ , American Heart Association 1

2 Development of HF Performance Measures: Process, Barriers, and Spinoffs Target: Heart Failure University of New Mexico School of Medicine Division of Cardiology

3 Objectives Describe the individual components of our process for ascertainment, clinical care, clinical follow-up (care transitions), data entry, and monitoring of HF patients in the University of New Mexico Hospital system. Demonstrate how these independent parts function together collaboration and cooperation and communication. Identify the early and late barriers and spin-offs with this process or What will get in your way!

4 Target: Heart Failure An AHA initiative launched in 2010 whose purpose is to improve quality, care transitions, and outcomes for patients with heart failure with a targeted initiative and leveraging the American Heart Association s premier quality improvement suite of resources including Get With The Guidelines-Heart Failure. Provide healthcare professionals with content-rich resources and materials designed to help them advance heart failure awareness, prevention, treatment and recovery. Participants must demonstrate > 50% compliance on the following measures: Medication optimization Early follow-up and care coordination Enhanced patient education

5 Target: Heart Failure ACEI/ARB at discharge Evidence-based beta-blocker at discharge Aldosterone Antagonist at discharge Follow-up visit within 7 days Referral to disease management program Patient education (at least 60 min) Interactive workbook

6 GWTG Target: HF University of New Mexico Hospital Performance

7

8

9

10

11

12 The Why and How of our Performance in 2012 Start: disarray in 9/2011 due to personnel changes Goals: Quality patient care (proactive) Complete, accurate data for GWTG Provider feedback (resident education) Dr. Cox receives from Dr. Dodendorf Dr. Cox sends alert to pre-defined group (Pharm, HF clinic, Quality) Dr. Cox orders Cardiac Rehab, HF nurse educator, smoking cessation education Chief Resident Quality Monthly orientation to Cardio ward Project: HF Medication Reconciliation at Discharge PharmD does monthly orientation on Cardio ward PharmD does Medication Reconciliation checks at discharge on Cardio ward Dr. Cox meets monthly with Coding Supervisor to resolve coding discrepancies Better alignment with Quality Outcomes reports to TJC, CMS Transitions of Care Coordination of Case Mgmt (Home Health, SNF, Rehab Ctrs), HF Clinic, Care One Program, Head Nurse on Cardio ward, HF Clinic nurse Pharmacy BNP List Compiled in MSExcel list Screened in Power Chart Power Chart message to Dr. Cox HF Pt List revised Electronic data sent to Dr. Dodendorf Composite to Dr. Cox and Chief Resident Quality Dedicated data entry Periodic reports to check data Reports to Quality Chief Resident Midas alerts Lighthouse initiations Daily Admit List Admits by Dr. Cox Comparison of UHC (after Coding & Billing) data with GWTG data Indepth study of readmits

13 Barriers into Spinoffs BARRIERS INTO SPINOFFS First Fix Better Fix First Fix Better Fix Goals: Quality patient care (proactive) Complete, accurate data for GWTG Provider feedback (resident education) Barrier Barrier Quality Patient Care Proactive approach to HF identification with early notice AND clinical alerts AND subsequent dialogue re: patient care, discharge planning, and outpatient care.

14 ASCERTAINMENT OF HF PATIENTS Dr. Cox receives from Dr. Dodendorf Dr. Cox sends alert to pre-defined group (Pharm, HF clinic, Quality) Dr. Cox orders Cardiac Rehab, HF nurse educator, smoking cessation education LINE of VISIBILITY Pharmacy BNP List Compiled in MSExcel list Screened in Power Chart Power Chart message to Dr. Cox HF Pt List revised Dedicated data entry Periodic reports to check data Reports to Quality Chief Resident Midas alerts Lighthouse initiations Daily Admit List Admits by Dr. Cox

15 Real-time Activation = Clinical Alerts/Clinical Orders Cardiac Rehab Outpatient HF Clinic RN Education Patient Quality Outcomes Pharmacy HF Nurse Educator

16 Clinical efforts Chief Resident Quality Monthly orientation on Cardio ward Project: HF Medication Reconciliation at Discharge Reports to Quality Chief Resident Clinical chart reviews Possible revisions to GWTG patient list Possible coding discrepancies

17 Medication Reconciliation PharmD does monthly orientation on Cardio ward PharmD does Medication Reconciliation checks at discharge on Cardio ward Improved compliance with GWTG standards Improved compliance with TJC, CMS standards Electronic data sent to Dr. Dodendorf Composite to Dr. Cox, PharmD, & Chief Resident Quality Dr. Cox provides feedback to resident including passing the rotation

18 Coding Issues Dr. Cox receives from Dr. Dodendorf Dr. Cox sends alert to pre-defined group (Pharm, HF clinic, Quality) Dr. Cox orders Cardiac Rehab, HF nurse educator, smoking cessation education Dr. Cox meets monthly with Coding Supervisor to resolve coding discrepancies Better alignment with Quality Outcomes reports to TJC, CMS Compiled in MSExcel list Screened in Power Chart Power Chart message to Dr. Cox HF Pt List revised Dedicated data entry Periodic reports to check data Reports to Quality Chief Resident Midas alerts Lighthouse initiations Daily Admit List Admits by Dr. Cox Comparison of UHC (after Coding & Billing) data with GWTG data

19 Discharge Planning Dr. Cox receives from Dr. Dodendorf Dr. Cox sends alert to pre-defined group (Pharm, HF clinic, Quality) Dr. Cox orders Cardiac Rehab, HF nurse educator, smoking cessation education Transitions of Care Coordination of Case Mgmt (Home Health, SNF, Rehab Ctrs), HF Clinic, Care One Program, Head Nurse on Cardio ward, HF Clinic nurse Compiled in MSExcel list Screened in Power Chart Power Chart message to Dr. Cox HF Pt List revised Dedicated data entry Periodic reports to check data Reports to Quality Chief Resident Midas alerts Lighthouse initiations Daily Admit List Admits by Dr. Cox Indepth study of readmits

20 Transition in Care The 7- day follow-up scheduled at discharge The 30-day visit data are ensured by use of dictation template (created by NP at HF Clinic) and the use of dedicated database (clinical outpatient database) Medication reconciliation at each step Role of out-patient pharmacy services at HF Clinic Cardiac Rehabilitation Nurse Education at HF Clinic (1/2 day/week)

21 Start: disarray in 9/2011 due to personnel changes Repeat Look at Process Goals: Quality patient care (proactive) Complete, accurate data for GWTG Provider feedback (resident education) Dr. Cox receives from Dr. Dodendorf Dr. Cox sends alert to pre-defined group (Pharm, HF clinic, Quality) Dr. Cox orders Cardiac Rehab, HF nurse educator, smoking cessation education Chief Resident Quality Monthly orientation to Cardio ward Project: HF Medication Reconciliation at Discharge PharmD does monthly orientation on Cardio ward PharmD does Medication Reconciliation checks at discharge on Cardio ward Dr. Cox meets monthly with Coding Supervisor to resolve coding discrepancies Better alignment with Quality Outcomes reports to TJC, CMS Transitions of Care Coordination of Case Mgmt (Home Health, SNF, Rehab Ctrs), HF Clinic, Care One Program, Head Nurse on Cardio ward, HF Clinic nurse Pharmacy BNP List Compiled in MSExcel list Screened in Power Chart Power Chart message to Dr. Cox HF Pt List revised Electronic data sent to Dr. Dodendorf Composite to Dr. Cox and Chief Resident Quality Dedicated data entry Periodic reports to check data Reports to Quality Chief Resident Midas alerts Lighthouse initiations Daily Admit List Admits by Dr. Cox Comparison of UHC (after Coding & Billing) data with GWTG data Indepth study of readmits

22 This process is like braiding 3 railroad tracks First railroad track : Clinical Processes Second railroad track : Identification and Ascertainment of HF Patients Third railroad track : Chart Abstraction and Data Entry (EMR and Outcomes software) Build in redundancy and backups Expect barriers actually they are a good thing!!

23 Questions? Comments? Reactions?

Post Discharge Pharmacy Phone Calls. Don Julian, RPh Pharmacy Director Deon Neal, Pharm D, Pharmacy Safety Specialist

Post Discharge Pharmacy Phone Calls. Don Julian, RPh Pharmacy Director Deon Neal, Pharm D, Pharmacy Safety Specialist Post Discharge Pharmacy Phone Calls Don Julian, RPh Pharmacy Director Deon Neal, Pharm D, Pharmacy Safety Specialist St. Mary s Medical Center Member of Ascension Health Number of Available Beds: 509 Admissions:

More information

Get With The Guidelines Best Practices: A look at reducing 30-day heart failure readmission rates

Get With The Guidelines Best Practices: A look at reducing 30-day heart failure readmission rates Get With The Guidelines Best Practices: A look at reducing 30-day heart failure readmission rates Thank you for joining the webinar! The presentation will begin shortly. *Please make sure your computer

More information

Heart Failure Best Practice Strategies: Featuring Target: HF Honor Roll Hospitals

Heart Failure Best Practice Strategies: Featuring Target: HF Honor Roll Hospitals Heart Failure Best Practice Strategies: Featuring Target: HF Honor Roll Hospitals 12/18/2013 12/18/13 2013, American Heart Association 1 Thank you for Joining the Webinar Today. The Presentation will Begin

More information

What do ACO s and Hospitals want from SNF s and CCRC s

What do ACO s and Hospitals want from SNF s and CCRC s What do ACO s and Hospitals want from SNF s and CCRC s Presented to the Institute of Senior Living, April 11, 2013 A Division of Kindred Healthcare 1 Assessing the match: What hospitals and ACO s currently

More information

Follow-Up Visits after Heart Failure Hospitalizations: Impact of a Medication Reconciliation Clinic

Follow-Up Visits after Heart Failure Hospitalizations: Impact of a Medication Reconciliation Clinic Follow-Up Visits after Heart Failure Hospitalizations: Impact of a Medication Reconciliation Clinic Sherry K. Milfred-LaForest, PharmD, BCPS Clinical Pharmacy Specialist, Cardiology and Organ Transplantation

More information

Leadership Summit for Hospital and Post-Acute Long Term Care Providers May 12, 2015

Leadership Summit for Hospital and Post-Acute Long Term Care Providers May 12, 2015 Leveraging the Continuum to Avoid Unnecessary Utilization While Improving Quality Leadership Summit for Hospital and Post-Acute Long Term Care Providers May 12, 2015 Karim A. Habibi, FHFMA, MPH, MS Senior

More information

Disclosure. Meaningful use 2009. Objectives. Meaningful use. Fundamentals of Transitions of Care (TOC)

Disclosure. Meaningful use 2009. Objectives. Meaningful use. Fundamentals of Transitions of Care (TOC) 47 th Annual Meeting August 2-4, 2013 Orlando, FL Fundamentals of Transitions of Care (TOC) Rebecca R. Prevost, B.S., Pharm.D., PSO Medication Safety Officer Florida Hospital Disclosure I do not have a

More information

Medication Reconciliation

Medication Reconciliation Medication Reconciliation Jackie Rice, RN EMR Team Supervisor Frederick Memorial Hospital Frederick, Maryland Scope of the Project Implement an automated medication reconciliation tool Meet the 2006 JCAHO

More information

Erlanger s Care Transitions. Working Together. UT Resident Orientation June 26, 2015

Erlanger s Care Transitions. Working Together. UT Resident Orientation June 26, 2015 Erlanger s Care Transitions Working Together UT Resident Orientation June 26, 2015 WHAT IS CARE TRANSITIONS? What is Care Transitions? A program that has been formed to meet and exceed CMS changes from

More information

Improving EMR Adoption, Utilization and Analytics: Working Towards Obtaining HIMSS Stage 7

Improving EMR Adoption, Utilization and Analytics: Working Towards Obtaining HIMSS Stage 7 Improving EMR Adoption, Utilization and Analytics: Working Towards Obtaining HIMSS Stage 7 About Ontario Shores-Our Vision Recovering Best Health Nurturing Hope Inspiring Discovery Our vision is bold and

More information

1. Executive Summary Problem/Opportunity: Evidence: Baseline Data: Intervention: Results:

1. Executive Summary Problem/Opportunity: Evidence: Baseline Data: Intervention: Results: A Clinical Nurse Leader led multidisciplinary Heart Failure Program: Integrating best practice across the care continuum to reduce avoidable 30 day readmissions. 1. Executive Summary Problem/Opportunity:

More information

Kaiser Permanente of Ohio

Kaiser Permanente of Ohio Kaiser Permanente of Ohio Chronic Disease Management Program March 11, 2011 Presenters: Amy Kramer and Audrey L. Callahan 1 Objectives 1. Define the roles and responsibilities of the Care Managers in the

More information

New Models of Care and Approaches to Payment

New Models of Care and Approaches to Payment New Models of Care and Approaches to Payment Richard Lopez, MD Chief Medical Officer Richard_Lopez@AtriusHealth.org September 30, 2014 Atrius Health Non-profit alliance of six leading independent medical

More information

RIH Transitions of Care Collaboration with Coastal Medical To Improve Transitions for Patients Discharged Hospital To Home

RIH Transitions of Care Collaboration with Coastal Medical To Improve Transitions for Patients Discharged Hospital To Home RIH Transitions of Care Collaboration with Coastal Medical To Improve Transitions for Patients Discharged Hospital To Home Sergio Petrillo, PharmD Clinical Pharmacist Specialist, Rhode Island Hospital

More information

Presented by: Char Brar, ACNP, MS(Chem.), MSN, RN Cardiology Nurse Practitioner JBVAMC, Chicago

Presented by: Char Brar, ACNP, MS(Chem.), MSN, RN Cardiology Nurse Practitioner JBVAMC, Chicago Presented by: Char Brar, ACNP, MS(Chem.), MSN, RN Cardiology Nurse Practitioner JBVAMC, Chicago 200 bed acute care facility 4 Community Based Out-patient Clinics (CBOCs) 58,000 Veterans IN FY 2008 : 768

More information

REACHING ZERO DEFECTS IN CORE MEASURES. Mary Brady, RN, MS Ed, Senior Nursing Consultant, Healthcare Transformations LLC,

REACHING ZERO DEFECTS IN CORE MEASURES. Mary Brady, RN, MS Ed, Senior Nursing Consultant, Healthcare Transformations LLC, REACHING ZERO DEFECTS IN CORE MEASURES Mary Brady, RN, MS Ed, Senior Nursing Consultant, Healthcare Transformations LLC, 165 Lake Linden Dr., Bluffton SC 29910, 843-364-3408, marybrady6@gmail.com Primary

More information

HealthEast Hospitals Policies Manual Nursing Service Administration Page 1 of 5

HealthEast Hospitals Policies Manual Nursing Service Administration Page 1 of 5 Nursing Service Administration Page 1 of 5 Owners/Group: Care Management Services HealthEast Nurse Practice Committee Policy No. HE Administrative Policy: 100.C-6 HENSA Policy T-7 POLICY TITLE: Discharge/Transfer/Care

More information

APPENDIX C CROSSWALK OF PPC-PCMH-CMS STANDARDS AND ELEMENTS TO MEDICAL HOME CAPABILITIES BY TIER

APPENDIX C CROSSWALK OF PPC-PCMH-CMS STANDARDS AND ELEMENTS TO MEDICAL HOME CAPABILITIES BY TIER APPENDIX C CROSSWALK OF PPC-PCMH-CMS STANDARDS AND ELEMENTS TO MEDICAL HOME CAPABILITIES BY TIER C.3 Table C.1. Crosswalk Between Tier Definitions (Table 2) and PPC-PCMH-CMS (Appendix B) PPC-PCMH-CMS

More information

Redesign of the Hospital Discharge: Patient-Centered Care to Improve Safety, Cost and Outcomes

Redesign of the Hospital Discharge: Patient-Centered Care to Improve Safety, Cost and Outcomes Redesign of the Hospital Discharge: Patient-Centered Care to Improve Safety, Cost and Outcomes Moderator: Donna Daniel, PhD, SNMHI Director, Practice Transformation and Measurement Speaker: Kelly McGrath,

More information

HealthCare Partners of Nevada. Heart Failure

HealthCare Partners of Nevada. Heart Failure HealthCare Partners of Nevada Heart Failure Disease Management Program 2010 HF DISEASE MANAGEMENT PROGRAM The HealthCare Partners of Nevada (HCPNV) offers a Disease Management program for members with

More information

Barriers to Care Coordination. Pitfalls. Ineffective Transitions Lead to Poor Outcomes

Barriers to Care Coordination. Pitfalls. Ineffective Transitions Lead to Poor Outcomes Eliminating the Pitfalls and Barriers to Reducing Rehospitalizations Evelyn Thompson RN,CMC Director of Care Transitions Genesis Healthcare October 2013 Barriers to Care Coordination System level barriers

More information

PHARMACY DEPARTMENT JOB DESCRIPTION PRE-REGISTRATION TRAINEE PHARMACIST. Chief Pharmacist (Pre-Registration Manager)

PHARMACY DEPARTMENT JOB DESCRIPTION PRE-REGISTRATION TRAINEE PHARMACIST. Chief Pharmacist (Pre-Registration Manager) PHARMACY DEPARTMENT JOB DESCRIPTION POST: PRE-REGISTRATION TRAINEE PHARMACIST BAND: 5 REPORTS AND RESPONSIBLE TO: ACCOUNTABLE TO: RELATIONSHIPS: Principal Pharmacist, Medicines Management (Pre- Registration

More information

Deploying Care Coordination and Care Transitions - Illinois

Deploying Care Coordination and Care Transitions - Illinois Deploying Care Coordination and Care Transitions - Illinois FLEX PROGRAM REVERSE SITE VISIT JUNE 23, 2015 Illinois Department of Public Health Center for Rural Health Flex Program grantee 15 years Illinois

More information

Connect4 Patients CCCM Primary Care Community. Presented By: Veronica Mansfield, DNP, APRN, AE-C, CCM Kit McKinnon, MBA, BSN, RN, CDE, CCM

Connect4 Patients CCCM Primary Care Community. Presented By: Veronica Mansfield, DNP, APRN, AE-C, CCM Kit McKinnon, MBA, BSN, RN, CDE, CCM Connect4 Patients CCCM Primary Care Community Presented By: Veronica Mansfield, DNP, APRN, AE-C, CCM Kit McKinnon, MBA, BSN, RN, CDE, CCM September 17, 2015 Objectives: Describe innovative care management

More information

Cardiac Rehab and Primary Care: Avoiding Losses in Care Transitions. Neville Suskin Heart & Stroke Clinical Update 2012

Cardiac Rehab and Primary Care: Avoiding Losses in Care Transitions. Neville Suskin Heart & Stroke Clinical Update 2012 Cardiac Rehab and Primary Care: Avoiding Losses in Care Transitions Neville Suskin Heart & Stroke Clinical Update 2012 1 Disclosure Med. Director SJHC CR Co-principal of Lawson e-cr application LCVIS SJHC

More information

Q&A with Harvard Vanguard Medical Associates and Atrius Health about Health Systems Change to Address Smoking

Q&A with Harvard Vanguard Medical Associates and Atrius Health about Health Systems Change to Address Smoking Q&A with Harvard Vanguard Medical Associates and Atrius Health about Health Systems Change to Address Smoking Background on Harvard Vanguard Medical Associates and Atrius Health Harvard Vanguard Medical

More information

Kaiser Permanente: Transition Care Performance and Strategies

Kaiser Permanente: Transition Care Performance and Strategies Kaiser Permanente: Transition Care Performance and Strategies Carol Ann Barnes, PT, DPT, GCS carbarne@gmail.com April 2009 Netta Conyers-Haynes, October, 2014 Principal Consultant, Communications Agenda

More information

Special Topics in Vendor- Specific Systems. Outline. Results Review. Unit 4 EHR Functionality. EHR functionality. Results Review

Special Topics in Vendor- Specific Systems. Outline. Results Review. Unit 4 EHR Functionality. EHR functionality. Results Review Special Topics in Vendor- Specific Systems Unit 4 EHR Functionality EHR functionality Results Review Outline Computerized Provider Order Entry (CPOE) Documentation Billing Messaging 2 Results Review Laboratory

More information

CCNC Care Management Standardized Plan

CCNC Care Management Standardized Plan Standardization & Reporting: Why is standardization important? Community Care Networks are responsible for the delivery of targeted care management services that will improve quality of care while containing

More information

Pediatric Residency Program American University of Beirut. In patients Experience Goals and Objectives

Pediatric Residency Program American University of Beirut. In patients Experience Goals and Objectives Pediatric Residency Program American University of Beirut In patients Experience Goals and Objectives The in patient rotation at AUB MC is based on a general pediatric ward in a tertiary care setting with

More information

State Action on Avoidable Rehospitalizations (STAAR) Initiative Gail A. Nielsen, Director of Learning and Innovation, Iowa Health System

State Action on Avoidable Rehospitalizations (STAAR) Initiative Gail A. Nielsen, Director of Learning and Innovation, Iowa Health System Session L20 This presenter has nothing to disclose State Action on Avoidable Rehospitalizations (STAAR) Initiative Gail A. Nielsen, Director of Learning and Innovation, Iowa Health System Orlando, FL December

More information

2/14/2015. Liz Cooke RN NP

2/14/2015. Liz Cooke RN NP Liz Cooke RN NP Quality of Life studies with HCT pts began at City of Hope in 1991 for Tool validation Retrospective Chart Review in 2000 of 100 HCT patients looking at readmission patterns. (published

More information

PREVENTING HEART FAILURE READMISSIONS

PREVENTING HEART FAILURE READMISSIONS PREVENTING HEART FAILURE READMISSIONS Tanya Sprinkle, BSN, RN, CCM Patient and Family Services Coordinator tanya.sprinkle@iredellmemorial.org 704-878-4534 Michelle Roseman, NHA, MBA Chief Operating Officer/Catawba

More information

Menu Case Study 3: Medication Administration Record

Menu Case Study 3: Medication Administration Record Menu Case Study 3: Medication Administration Record Applicant Organization: Ontario Shores Centre for Mental Health Sciences Organization s Address: 700 Gordon Street, Whitby, Ontario, Canada, L1N5S9 Submitter

More information

Ensure Timely Post-Hospital Care Follow-Up

Ensure Timely Post-Hospital Care Follow-Up Ensure Timely Post-Hospital Care Follow-Up Peg Bradke and Eric Coleman February 3, 2011 These presenters have nothing to disclose. Session Objectives Participants will be able to: Provide an overview of

More information

Technician Learning Objectives 3/25/2014. Pharmacy Practice Changes in ACA Accountable Care Organizations

Technician Learning Objectives 3/25/2014. Pharmacy Practice Changes in ACA Accountable Care Organizations Pharmacy Practice Changes in ACA Accountable Care Organizations Avani S. Desai, PharmD & Emory S. Martin PharmD Sunday, April 12, 2014 9:05 10:05 am Pharmacist Learning Objectives At the conclusion of

More information

Patients Receive Recommended Care for Community-Acquired Pneumonia

Patients Receive Recommended Care for Community-Acquired Pneumonia Patients Receive Recommended Care for Community-Acquired Pneumonia For New Jersey to be a state in which all people live long, healthy lives. DSRIP LEARNING COLLABORATIVE PRESENTATION The Care you Trust!

More information

Helen M. Simpson Rehabilitation Hospital Leveraging IT to Coordinate Care Transitions

Helen M. Simpson Rehabilitation Hospital Leveraging IT to Coordinate Care Transitions Helen M. Simpson Rehabilitation Hospital Leveraging IT to Coordinate Care Transitions All speakers have completed commercial bias disclosure forms and do not have any conflicts of interest Disclosures

More information

3/16/2016. Preventing Readmissions Through Compliant Patient Transitions. Transition of Care Statistics. Care Transitions The Regulatory Environment

3/16/2016. Preventing Readmissions Through Compliant Patient Transitions. Transition of Care Statistics. Care Transitions The Regulatory Environment Preventing Readmissions Through Compliant Patient Transitions Deborah L. Carlino, RN, MBA, CHC, CHRC Director of Healthcare Compliance and Audit - Rutgers, The State University of New Jersey Melanie A.

More information

Meaningful Use. Goals and Principles

Meaningful Use. Goals and Principles Meaningful Use Goals and Principles 1 HISTORY OF MEANINGFUL USE American Recovery and Reinvestment Act, 2009 Two Programs Medicare Medicaid 3 Stages 2 ULTIMATE GOAL Enhance the quality of patient care

More information

Preceptor Affiliate Clinical Instructor Application and Information Form

Preceptor Affiliate Clinical Instructor Application and Information Form Preceptor Affiliate Clinical Instructor Application and Information Form We MUST have this information on file for all preceptors engaged in teaching our students in experiential coursework. The form must

More information

Now Hiring!!! Clerical. Requirements

Now Hiring!!! Clerical. Requirements Now Hiring!!! Title Req Num Facility Department Section Schedule Shift Clerical ED Interviewer 3864 TGMC Emergency Occasional Varied Shifts Validates and registers all patients' demographic, medical and

More information

Medical University of South Carolina

Medical University of South Carolina Medical University of South Carolina Value Collaborative: 90-Day Sprint Report-out Presenter Name, Title January 25, 2016 01 Vision 1. What problem are you trying to fix? MUSC Children s Hospital has experienced

More information

Cheri Basso BSN, RN-BC,CHFN Hospital Initiatives to Improve Outcomes. FINANCIAL DISCLOSURE: No relevant financial relationship exists

Cheri Basso BSN, RN-BC,CHFN Hospital Initiatives to Improve Outcomes. FINANCIAL DISCLOSURE: No relevant financial relationship exists Cheri Basso BSN, RN-BC, CHFN Mary Washington Healthcare Fredericksburg, VA Cheri Basso BSN, RN-BC,CHFN Hospital Initiatives to Improve Outcomes FINANCIAL DISCLOSURE: No relevant financial relationship

More information

Kick off Meeting November 11 13, 2015. MERCY CLINIC EAST COMMUNITIES Management of Patients with Heart Failure (HF)

Kick off Meeting November 11 13, 2015. MERCY CLINIC EAST COMMUNITIES Management of Patients with Heart Failure (HF) Kick off Meeting November 11 13, 2015 MERCY CLINIC EAST COMMUNITIES Management of Patients with Heart Failure (HF) Team Composition Justin Huynh, MD Internal Medicine, Physician Champion Mary Laubinger,

More information

Physician Practice Connections Patient Centered Medical Home

Physician Practice Connections Patient Centered Medical Home Physician Practice Connections Patient Centered Medical Home Getting Started Any practice assessing its ability to achieve NCQA Physician Recognition in PPC- PCMH is taking a bold step toward aligning

More information

Introduction. Mary Collier RN, MSN. Monica Worrell RN,MSN

Introduction. Mary Collier RN, MSN. Monica Worrell RN,MSN UC Health Introduction Mary Collier RN, MSN Monica Worrell RN,MSN OBJECTIVES Discuss Evidence Based Practice Highlight UC Health Medical Centers Heart Failure Clinical Practice Guidelines Share our Heart

More information

PHS-Connect Users Group Forum. November 7, 2013

PHS-Connect Users Group Forum. November 7, 2013 PHS-Connect Users Group Forum November 7, 2013 Agenda Introductions and Opening Remarks PHS-Connect Update Direction of PHS-Connect What can PHS-Connect Do for Me and My EMR Secure Messaging for MU2 and

More information

Optum s Role in Mycare Ohio

Optum s Role in Mycare Ohio Optum s Role in Mycare Ohio What is MyCare Ohio? New opportunities generated by the Affordable Care Act have allowed Ohio to implement the MyCare Ohio program. MyCare Ohio is a demonstration project that

More information

CHAPTER 535 HEALTH HOMES. Background... 2. Policy... 2. 535.1 Member Eligibility and Enrollment... 2. 535.2 Health Home Required Functions...

CHAPTER 535 HEALTH HOMES. Background... 2. Policy... 2. 535.1 Member Eligibility and Enrollment... 2. 535.2 Health Home Required Functions... TABLE OF CONTENTS SECTION PAGE NUMBER Background... 2 Policy... 2 535.1 Member Eligibility and Enrollment... 2 535.2 Health Home Required Functions... 3 535.3 Health Home Coordination Role... 4 535.4 Health

More information

Joint Implementation of Epic Ambulatory in Two Academic Centers

Joint Implementation of Epic Ambulatory in Two Academic Centers Joint Implementation of Epic Ambulatory in Two Academic Centers Tara Coxon Director, Information Technology St. Joseph s Healthcare, Hamilton Rob Lloyd MD FRCPC Medical Director, Clinical Informatics Hamilton

More information

The 4 Pillars of Clinical Integration: A Flexible Model for Hospital- Physician Collaboration

The 4 Pillars of Clinical Integration: A Flexible Model for Hospital- Physician Collaboration The 4 Pillars of Clinical Integration: A Flexible Model for Hospital- Physician Collaboration Written by Daniel J. Marino, President & CEO, Health Directions November 14, 2012 Originally published by Becker

More information

Person-Centered Nurse Care Management in Home Based Care: Impact on Well-Being and Cost Containment

Person-Centered Nurse Care Management in Home Based Care: Impact on Well-Being and Cost Containment Person-Centered Nurse Care Management in Home Based Care: Impact on Well-Being and Cost Containment Donna Zazworsky, RN, MS, CCM, FAAN Vice President: Community Health and Continuum Care Carondelet Health

More information

Orientation to Sevocity Electronic c Medical Record Geriatrics Rotation INPATIENT OR OUTPATIENT? The First part of this presentation is the OUTPATIENT Orientation Special issues for INPATIENT documentation

More information

Accountable Care Organization Framework for Pharmaceuticals

Accountable Care Organization Framework for Pharmaceuticals Accountable Care Organization Framework for Pharmaceuticals Speakers Eleanor M. Perfetto, PhD, MS Senior Director, Reimbursement & Regulatory Affairs, Federal Government Relations Pfizer Inc. Robert W.

More information

The HeartStart Experience. Jessica Auer HeartStart Cardiac Rehabilitation Program Manager Bundaberg Health Promotions Ltd

The HeartStart Experience. Jessica Auer HeartStart Cardiac Rehabilitation Program Manager Bundaberg Health Promotions Ltd The HeartStart Experience Jessica Auer HeartStart Cardiac Rehabilitation Program Manager Bundaberg Health Promotions Ltd HeartStart Program 1994-2013 Cardiac Rehabilitation Program Phase II & Phase III

More information

Improving the Health Care Journey to Cardiac Rehabilitation for Victorian Aboriginal Patients

Improving the Health Care Journey to Cardiac Rehabilitation for Victorian Aboriginal Patients Improving the Health Care Journey to Cardiac Rehabilitation for Victorian Aboriginal Patients Lorraine Parsons, Manager Programs Raelene Lesniowska, Senior Metropolitan ICAP Project Officer Aboriginal

More information

Transitions of Care Management Coding (TCM Code) Tutorial. 1. Introduction Meaning of moderately and high complexity 2

Transitions of Care Management Coding (TCM Code) Tutorial. 1. Introduction Meaning of moderately and high complexity 2 Transitions of Care Management Coding (TCM Code) Tutorial Index 1. Introduction Meaning of moderately and high complexity 2 2. SETMA s Tools for using TCM Code 3 Alert that patient is eligible for TCM

More information

Reducing Readmissions with Predictive Analytics

Reducing Readmissions with Predictive Analytics Reducing Readmissions with Predictive Analytics Conway Regional Health System uses analytics and the LACE Index from Medisolv s RAPID business intelligence software to identify patients poised for early

More information

Idaho Health Home State Plan Amendment Matrix: Summary Overview. Overview of Approved Health Home SPAs

Idaho Health Home State Plan Amendment Matrix: Summary Overview. Overview of Approved Health Home SPAs Idaho Health Home State Plan Amendment Matrix: Summary Overview This matrix outlines key program design features from health home State Plan Amendments (SPAs) approved by the Centers for Medicare & Medicaid

More information

KNOWLEDGEABLE SERVICE ROBOTS FOR AGING

KNOWLEDGEABLE SERVICE ROBOTS FOR AGING KNOWLEDGEABLE SERVICE ROBOTS FOR AGING Workshop on ICT and Robotics for Care and Service An advanced care system Hamburg December 2012 Dr. Hadas Lewy Maccabi Healthcare Services Maccabi Healthcare Services

More information

EnduraCare. We are committed to exceeding our customers expectations.

EnduraCare. We are committed to exceeding our customers expectations. AmEriCA s leading provider of hospital therapy services We are committed to exceeding our customers expectations. We re not just out to change the world of therapy, we re actually changing it. services

More information

Mark Thomas, Director of Health Informatics Mr Graham Putnam CCIO Steve Shanahan, Executive Director of Finance. IM&T Committee

Mark Thomas, Director of Health Informatics Mr Graham Putnam CCIO Steve Shanahan, Executive Director of Finance. IM&T Committee Report to Trust Board of Directors Date of Meeting: 2 nd June 2015 Enclosure Number: 3 Title of Report: Author: Executive Lead: Responsible Sub- Committee (if appropriate): Executive Summary: Information

More information

Berkshire Medical Center Heart Failure Program

Berkshire Medical Center Heart Failure Program Berkshire Medical Center Heart Failure Program Reducing Readmissions A Multi Disciplinary Approach 1 Project Goals To improve the overall care of Berkshire County Heart Failure Patients Reduce 30 day readmission

More information

Going the Distance with Behavioral Health Core Measures Workflow Changes to Canopy. Go-Live: July 23, 2015

Going the Distance with Behavioral Health Core Measures Workflow Changes to Canopy. Go-Live: July 23, 2015 Going the Distance with Behavioral Health Core Measures Workflow Changes to Canopy Go-Live: July 23, 2015 Learning Objectives Provide an overview of core measures and their importance Describe the enhancements

More information

Best Practices in Managing Patients With Chronic Obstructive Pulmonary Disease (COPD)

Best Practices in Managing Patients With Chronic Obstructive Pulmonary Disease (COPD) Best Practices in Managing Patients With Chronic Obstructive Pulmonary Disease (COPD) Harvard Vanguard Medical Associates Case Study Organization Profile Founded in the 1960s, Harvard Vanguard Medical

More information

Joan Carroll RN, CDMS, CCM Director of Care Transitions Lee Memorial Health System

Joan Carroll RN, CDMS, CCM Director of Care Transitions Lee Memorial Health System Joan Carroll RN, CDMS, CCM Director of Care Transitions Lee Memorial Health System 1 Explain how patients experience transitions of care Identify variables that affect transitions due to lack of patient

More information

Disease Management Identifications and Stratification Health Risk Assessment Level 1: Level 2: Level 3: Stratification

Disease Management Identifications and Stratification Health Risk Assessment Level 1: Level 2: Level 3: Stratification Disease Management UnitedHealthcare Disease Management (DM) programs are part of our innovative Care Management Program. Our Disease Management (DM) program is guided by the principles of the UnitedHealthcare

More information

Quality Improvement Plan (QIP) Narrative for Health Care Organizations in Ontario 3/15/2016

Quality Improvement Plan (QIP) Narrative for Health Care Organizations in Ontario 3/15/2016 Quality Improvement Plan (QIP) Narrative for Health Care Organizations in Ontario 3/15/2016 This document is intended to provide health care organizations in Ontario with guidance as to how they can develop

More information

Facing Healthcare Administration Challenges

Facing Healthcare Administration Challenges Facing Healthcare Administration Challenges Healthcare provider administration tasks, are facing different types of challenges. The delivery of health care services is the most visible part of any health

More information

Readmissions as an Enterprise Priority. Presenters 4/17/2014

Readmissions as an Enterprise Priority. Presenters 4/17/2014 Readmissions as an Enterprise Priority April 24, 2014 Presenters Vincent A. Maniscalco, MPA, LNHA Administrator Middletown Park Rehabilitation and Health Care Center Vmaniscalco@parkmanorrehab.com Eileen

More information

Population Health Management: Banner Health Network s Perspective. Neta Faynboym, Medical Director Banner Health Network

Population Health Management: Banner Health Network s Perspective. Neta Faynboym, Medical Director Banner Health Network Population Health Management: Banner Health Network s Perspective Neta Faynboym, Medical Director Banner Health Network 29 Acute Care Hospitals BANNER AT A GLANCE Banner Health Network with 400K lives

More information

A Team Approach to Creating a Seamless COPD clinic in a FHT Setting. Judy Cobus, RN Karen Dubé, PCNP Ellen Holmes, RRT, RCPT(P), CRE

A Team Approach to Creating a Seamless COPD clinic in a FHT Setting. Judy Cobus, RN Karen Dubé, PCNP Ellen Holmes, RRT, RCPT(P), CRE A Team Approach to Creating a Seamless COPD clinic in a FHT Setting Judy Cobus, RN Karen Dubé, PCNP Ellen Holmes, RRT, RCPT(P), CRE January 2015 Disclosures: Better Breathing Program Objectives To Overview

More information

#Aim2Innovate. Share session insights and questions socially. UCLA Primary Care Innovation Model 6/13/2015. Mark S. Grossman, MD, MBA, FAAP, FACP

#Aim2Innovate. Share session insights and questions socially. UCLA Primary Care Innovation Model 6/13/2015. Mark S. Grossman, MD, MBA, FAAP, FACP UCLA Primary Care Innovation Model Mark S. Grossman, MD, MBA, FAAP, FACP Chief Medical Office, UCLA Community Physicians & Specialty Care Networks June 16, 2015 DISCLAIMER: The views and opinions expressed

More information

Nursing Home to Community Program: A Discharge Planning Manual

Nursing Home to Community Program: A Discharge Planning Manual Nursing Home to Community Program: A Discharge Planning Manual March 2006 Portions of this Manual may be cited on condition that proper credit is given to: Broome County Community Alternative Systems Agency

More information

Cardiac Rehabilitation Information Systems (CRIS)

Cardiac Rehabilitation Information Systems (CRIS) Cardiac Rehabilitation Information Systems (CRIS) [D Lavin, D Hevey, H McGee, D De La Harpe, M Kiernan and E Shelley] M. Rachel Flynn Royal College of Surgeons in Ireland April 2005 Background Cardiovascular

More information

Memo. Health Care Management. From: Deborah Jenkins, Admissions/Transfer Manager Date: 10/21/2010 Re: HCM October/November/December 2010 Call Schedule

Memo. Health Care Management. From: Deborah Jenkins, Admissions/Transfer Manager Date: 10/21/2010 Re: HCM October/November/December 2010 Call Schedule Health Care Management Memo From: Deborah, Admissions/Transfer Manager Date: // Re: HCM October/November/December Call Schedule The attached list is the October/November/December call schedule for the

More information

Reimbursement for Clinical Pharmacy Services: Is There a Role for Facility Billing?

Reimbursement for Clinical Pharmacy Services: Is There a Role for Facility Billing? Reimbursement for Clinical Pharmacy Services: Is There a Role for Facility Billing? Edith A. Nutescu, Pharm.D., FCCP Laura D. Roller, Pharm.D., BCPS, CACP Current Billing Models: Clinical Pharmacy Services

More information

Increase accuracy and completeness of clinical documentation. Optimize reimbursement and improve productivity

Increase accuracy and completeness of clinical documentation. Optimize reimbursement and improve productivity TherapySource is a complete clinical and administrative physical therapy software solution. It is a comprehensive therapy practice management software with the most advanced clinical documentation knowledge

More information

Quick Reference Information: Coverage and Billing Requirements for Medicare Ambulance Transports

Quick Reference Information: Coverage and Billing Requirements for Medicare Ambulance Transports DEPARTMENT OF HEALTH AND HUMAN SERVICES Centers for Medicare & Medicaid Services Quick Reference Information: Coverage and Billing Requirements for Medicare Ambulance Transports ICN 909008 August 2014

More information

M E D I C AL D I AG N O S T I C S P E C I AL I S T Schematic Code 14251 (31000081)

M E D I C AL D I AG N O S T I C S P E C I AL I S T Schematic Code 14251 (31000081) I. DESCRIPTION OF WORK M E D I C AL D I AG N O S T I C S P E C I AL I S T Schematic Code 14251 (31000081) Positions in this banded class perform skilled technical work in the administration of specialized

More information

Best Practices in Managing Patients With Chronic Obstructive Pulmonary Disease (COPD)

Best Practices in Managing Patients With Chronic Obstructive Pulmonary Disease (COPD) Best Practices in Managing Patients With Chronic Obstructive Pulmonary Disease (COPD) Novant Health Case Study Profile Novant Health includes a physician-led division composed of 1150 physician partners

More information

EMC: A Consultant s Perspective. MoHCA 2 nd National Summit on EMC March 26, 2003

EMC: A Consultant s Perspective. MoHCA 2 nd National Summit on EMC March 26, 2003 EMC: A Consultant s Perspective MoHCA 2 nd National Summit on EMC March 26, 2003 Conflicting and Competing Message VIEWPOINTS Electronic Magnetic Compatibility (Interference) Supporting Clinicians Through

More information

Practice Readiness Assessment

Practice Readiness Assessment Practice Demographics Practice Name: Tax ID Number: Practice Address: REC Implementation Agent: Practice Telephone Number: Practice Fax Number: Lead Physician: Project Primary Contact: Lead Physician Email

More information

RT AS PROJECT MANAGER:

RT AS PROJECT MANAGER: RT AS PROJECT MANAGER: IMPROVING CARE TRANSITIONS DECREASES UNPLANNED READMISSIONS TAMMY JARNAGIN, BHS, RRT DIRECTOR CARDIOPULMONARY SERVICES, NEURODIAGNOSTICS, HOME MEDICAL EQUIPMENT Objectives Recognize

More information

EMR Adoption Model. Handbook

EMR Adoption Model. Handbook EMR Adoption Model Handbook Version 3.0 Morgan Price, James Lai, Tyrone Austen, and Jes Bassi Feb. 17, 2011 Overview Physicians across the country and even the world are migrating from entirely paper-based

More information

Senate Special Committee on Aging

Senate Special Committee on Aging Senate Special Committee on Aging Field Hearing July 31, 2015 Five Star Senior Center, St. Louis, Missouri Testimony Delivered by Sandra Van Trease Group President, BJC HealthCare Introduction Members

More information

Learning Collaborative

Learning Collaborative Care Transitions Intervention Model to Reduce 30-Day Readmissions for Chronic Cardiac Conditions Learning Collaborative Dr. Norma Jean-Francois, DNP, APN-C Dr. Mary Anne Marra, DNP, MSN, RN, NEA-BC 1 OVERVIEW

More information

Business Profile. Health Contact Centre

Business Profile. Health Contact Centre Business Profile Health Contact Centre March 2014 Contents 1. Background... 1 2. HCC Services... 1 2.1 Customer Phone services... 3 2.1.1 General health information and screening... 3 2.1.2 Teletriage

More information

High Rehospitalization Rates: Evaluation and Impact

High Rehospitalization Rates: Evaluation and Impact High Rehospitalization Rates: Evaluation and Impact May 29, 2009 Denise Remus, PhD, RN Chief Quality Officer, BayCare Health System BayCare Health System BayCare is the largest full-service, community-based

More information

Clinical Integration Concepts for Successful Population Health

Clinical Integration Concepts for Successful Population Health Annual Conference November 12, 2015 Presented by: Jane Jerzak, RN, CPA, Partner Clinical Integration Concepts for Agenda Population Health and the Movement Toward Clinical Integration Consumerism Patient

More information

The new Cardiac Nurse Practitioner candidate position at Austin Health

The new Cardiac Nurse Practitioner candidate position at Austin Health The new Cardiac Nurse Practitioner candidate position at Austin Health The new Cardiac Nurse Practitioner (NP) candidate position offered by Austin Health is also the first Cardiac NP candidate position

More information

Belfast Breathing Better: A COPD Collaborative. Anne Marie Marley Respiratory Nurse Consultant BHSCT

Belfast Breathing Better: A COPD Collaborative. Anne Marie Marley Respiratory Nurse Consultant BHSCT Belfast Breathing Better: A COPD Collaborative Anne Marie Marley Respiratory Nurse Consultant BHSCT Stage 1a Primary Care Primary prevention Health promotion and education Stage 1b General Practice Accurate

More information

2013 ACO Quality Measures

2013 ACO Quality Measures ACO 1-7 Patient Satisfaction Survey Consumer Assessment of HealthCare Providers Survey (CAHPS) 1. Getting Timely Care, Appointments, Information 2. How well Your Providers Communicate 3. Patient Rating

More information

HealthEast Care Naviga0on Strategy February 17, 2011

HealthEast Care Naviga0on Strategy February 17, 2011 HealthEast Care Naviga0on Strategy February 17, 2011 Rahul Koranne, MD, MBA, FACP Series Objec+ves At the conclusion of this learning activity, participants will be able to: 1. Identify key changes and

More information

Health Information Technology and the National Quality Agenda. Daphne Ayn Bascom, MD PhD Chief Clinical Systems Officer Medical Operations

Health Information Technology and the National Quality Agenda. Daphne Ayn Bascom, MD PhD Chief Clinical Systems Officer Medical Operations Health Information Technology and the National Quality Agenda Daphne Ayn Bascom, MD PhD Chief Clinical Systems Officer Medical Operations Institute of Medicine Definition of Quality "The degree to which

More information

Be Careful What You Ask For A Predictive Model That Really Works

Be Careful What You Ask For A Predictive Model That Really Works Be Careful What You Ask For A Predictive Model That Really Works Rod Christensen, MD President, Allina Health Clinics Cheryl Hermann, RN, MBA Vice President, Clinic Operations & Patient Care Services Karen

More information

Comprehensive Cardiac Care Program

Comprehensive Cardiac Care Program PrograM Comprehensive Cardiac Care Program Empowering you to strengthen your heart. Trust In Our Care. Trust in Our Care The Comprehensive Cardiac Care Program is physician directed and focused on assisting

More information

Organization: MedStar Union Memorial Hospital. Solution Title: Call 911: Our Documentation Died! Program/Project Description, including Goal:

Organization: MedStar Union Memorial Hospital. Solution Title: Call 911: Our Documentation Died! Program/Project Description, including Goal: Organization: MedStar Union Memorial Hospital Solution Title: Call 911: Our Documentation Died! Program/Project Description, including Goal: Our Emergency Department (ED) converted to an electronic medical

More information

Vertebral Fragility Fracture

Vertebral Fragility Fracture CLINICAL PATHWAY Musculoskeletal Health Vertebral Fragility Fracture Vertebral Fragility Fracture Table of Contents (tap to jump to page) INTRODUCTION 1 Key Points of the Vertebral Fragility Fracture Pathway

More information